Erik Björkman, vice president and general manager, EMEA at Dexcom, writes about the technology can help diabetes patients as well as the challenges they face.
In Europe there are an estimated 58 million (source: 2017 WHO) people living with Type 1 or Type 2 diabetes. Of this 58 million, more than half are considered high-risk. This group of patients includes those that are hypo unaware, nocturnal hypos, children or have a high glycaemic variability. Technology is an important solution to many healthcare issues, and diabetes is no exception. Continuous Glucose Monitoring (CGM), a discreet, life-saving technology used to track glucose levels throughout the day and night, is one such technology making waves in the diabetes community.
The Technology Revolution
CGM systems take glucose measurements at regular intervals, 24 hours a day, and translate the readings into dynamic data, generating glucose direction and rate of change reports. There is an insurmountable amount of anxiety amongst those with diabetes, from the stressors of accurate meal planning and scheduling to constant glucose monitoring and trips to their doctors or A&E.
CGM systems provide people with diabetes with need real-time monitoring, which is especially life-saving when sleeping, alerts and alarms. It also provides the comfort of always knowing product accuracy is correct so that they can make treatment decisions in real-time. In terms of clinical benefits, the use of CGM for those requiring tight glycaemic control, are undeniable. When you wear a CGM device, it can give you a much better understanding of how exercise affects your glucose levels, how your body reacts to certain foods and how stress can impact your body.
The technology has the potential to transform patient’s lives and lower overall healthcare costs thanks to improved control of diabetes. Unfortunately, access to this technology is limited, as there is no national funding for CGM through the NHS. It’s important for these individuals to have the best possible care available, because what many don’t realise are the insurmountable mental health effects that the condition has on individuals.
Mental Health Impacts
High-risk patient groups are at an even higher risk of falling victim to high levels of stress and anxiety due to the severity of their condition. In fact, according to a recent survey of more than 800 people with diabetes in Britain, almost 50% said the thought of constantly having to check their sugar levels in order to avoid a potentially fatal attack caused them to experience prolonged feelings of stress, anguish and anger. Further, the majority (62%) said they worried more about of the risk of developing further health complications linked to diabetes, such as blindness and limb amputations.
If you thought the stressors ended there, you were gravely wrong. Many people with diabetes feel that the general public don’t understand the condition, with one in five feeling that people wrongly judge them when they have to inject in public, and 27% saying they feel people think they should do it in private. This can put tremendous strain on them, their families, friends and co-workers – resulting in those with the condition to not inject at all. Having access to discreet technology like CGM greatly assuages many of these anxieties, making living with Type 1 diabetes less stressful.
Surprisingly, one area where individuals are still facing issues is in the workplace. Of those in the workforce, a quarter said they had to take more than three days off work in the last year because of their condition, and almost one in five have been disciplined by their bosses for taking that time off. Another 25% claimed they had been questioned about sick days they had taken, while 12% said they had been refused time off – despite employment laws banning the discrimination of people with health conditions. Having to cope with the day-to-day struggles of diabetes is difficult enough without the pressure people with diabetes appear to be under as they try to continue to work and progress in their careers. CGM technology provides detailed data and trends into individuals’ glucose levels, allowing them to make informed decisions about their dosing and preventative care.
Education is a great way to overcome fear and anxiety, with many people living with diabetes now turning to technology like CGM to help manage their condition on a daily basis – it’s part of a continuing revolution in diabetes care. Unlike a finger stick measurement, which measures a static point of time, but gives no indication if glucose levels are rising or falling, CGM allows users to see trends over time and therefore help users make better-informed decisions as part of any insulin regime. This means patients can avoid complications that directly link to mental health issues, illness causing them to miss work, and numerous trips to hospital.
However, if a patient wants to use CGM long-term, it will need to be funded it in some way – something that is not available for everyone. There are strict criteria set out by NICE around who is eligible, which includes having the following:
- More than one severe hypo a year with no obvious cause
- Complete hypo unawareness
- More than 2 hypos a week, with no symptoms and which affect day to day life extreme fear of hypos
- An HbA1c level of 75mmols/mol despite testing at least 10 times a day
Innovations like this are critical to patient care – alleviating the burden diabetes can sometimes have on individuals that live with it. But with restrictions on who has access to this technology, it’s extremely limiting. It’s time we all realise that funding for CGM not only helps the patients immensely, it helps control diabetes overall and provides better understanding into the trends of the disease.